Provider Demographics
NPI:1326232638
Name:REYNOLDS, ABIGALE ELIZABETH (PHARMD)
Entity Type:Individual
Prefix:
First Name:ABIGALE
Middle Name:ELIZABETH
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13006 EDSEL DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-5694
Mailing Address - Country:US
Mailing Address - Phone:304-838-0768
Mailing Address - Fax:
Practice Address - Street 1:13006 EDSEL DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-5694
Practice Address - Country:US
Practice Address - Phone:919-646-7367
Practice Address - Fax:919-404-2103
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19168183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist